Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Apr 2020
Meta AnalysisEffect of General and Non-general Anesthesia on Postoperative Cognitive Dysfunction.
ABATRACT Controversy exists in the effect of general anesthesia and non-general anesthesia on postoperative cognitive dysfunction (POCD). The authors aimed to perform this systematic review to comprehensively assess the effect of general anesthesia or non-general anesthesia on POCD. Relative studies from the online literature database were retrieved. ⋯ In conclusion, when compared with the non-general anesthesia, general anesthesia increases the incidence of POCD in patients within three days after surgery, but makes no difference after seven days. It suggests that early intervention should be conducted on patients undergoing general anesthesia. Key Words: General anesthesia, Postoperative cognitive dysfunction, Meta-analysis.
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J Coll Physicians Surg Pak · Mar 2020
Effect of Erythropoiesis Stimulating Agents on Clinical Outcomes in Breast Cancer Patients: A Systematic Review of Randomised Controlled Trials.
The impact of erythropoiesis stimulating agents (ESAs) on clinical outcomes among breast cancer patients is debatable. Current review is aimed to ascertain the efficacy of ESAs among breast cancer patients. Randomised controlled trials (RCTs) were electronically searched. ⋯ Erythropoietin reported no mortality, TEEs, serious ADRs and tumor progression. About 9% patients required transfusions during ESA therapy. Current evidence suggests that use of ESA reduces transfusion need but increases mortality and risks of TEEs.
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J Coll Physicians Surg Pak · Feb 2020
ReviewTopical Fluorides for Head and Neck Cancer Patients Subjected to Surgical Resection and Radiation Therapy in Resource Restraint Settings.
Patients undergoing surgical resection and ionizing radiations for the treatment of head and cancer may lead a challenging life even after the cure of the disease; because these procedures can adversely affect the oral mucosa, salivary gland, bone, masticatory musculature, and the dentition. Especially, if major salivary glands are exposed to high dose radiation, an irreversible xerostomia may occur that can lead to rampant dental caries. ⋯ The healthcare providers should work together in a team to prevent or manage these complications and improve the lives of the patients. This review paper focuses on the significance of low cost fluoride treatment for salvaging the dentition among patients who have had developed head and neck carcinoma and later got subjected to surgical resection and radiation therapy.
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J Coll Physicians Surg Pak · Feb 2020
Prevalence and Determinants of Anemia among Women of Reproductive Age in Developing Countries.
Anemia is one of the major causes of maternal mortality and morbidity across the globe, affecting around two-thirds of pregnant women in developing countries. The objective of this study was to synthesise study findings regarding the prevalence and determinants of anemia among women of reproductive age in developing countries. A total of 28 articles were reviewed by two authors for preliminary screening after removing overlapping information. ⋯ The average prevalence of anemia was found to be 46.5% with a range of 18.1% to 75% in different studies. Factors such as increased maternal age, low education, high parity, poor socio-economic status, poor nutritional status, and certain diseases have been found as important determinants of anemia. There is a need to improve the socio-economic status, literacy, diet and general health of poor women in developing countries.
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The postpericardiotomy syndrome (PPS) is an important cause of morbidity and mortality following heart operation. This systematic review reviewed the literature regarding PPS. It was found to occur on day 18.3 ±15.9 after cardiac operations, most often after coronary artery bypass grafting, and mitral valve replacement. ⋯ Surgical trauma and cardiopulmonary bypass trigger the systemic inflammatory response, which results in antiheart autoantigen release, and the deposited immune complex could be found in the pericardial, pleural, and lung tissues, thereby provoking the occurrence of PPS. Therapeutic options for the refractory cases are long-term oral corticoids or pericardiectomy. Surgical intervention was warranted in 2.6% of the cases due to cardiac tamponade.